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Vitrectomy

Surgery Overview

Vitrectomy is the surgical removal of the
vitreous gel from the middle of the
eye. It may be done when there is a
retinal detachment, because removing the vitreous gel
gives your eye doctor (ophthalmologist) better access to the
back of the eye. The vitreous gel may also be removed if blood in the vitreous
gel (vitreous hemorrhage) does not clear on its own.

During a
vitrectomy, the surgeon inserts small instruments into the eye, cuts the
vitreous gel, and suctions it out. After removing the vitreous gel, the surgeon
may treat the
retina with a laser (photocoagulation), cut or remove
fibrous or scar tissue from the retina, flatten areas where the retina has
become detached, or repair tears or holes in the retina or
macula.

At the end of the surgery,
silicone oil or a gas bubble is injected into the eye to lightly press the retina against the wall of the eye. Oil cannot be absorbed by the body, so if an oil bubble is used, you'll need a second procedure to remove the oil after the retinal detachment has healed.

Vitrectomy is
always done by an eye doctor who has special training in treating problems of
the retina.

What To Expect After Surgery

Vitrectomy may require an overnight
hospital stay. But it may sometimes be done as
outpatient surgery. The surgery lasts 2 to 3 hours.
Your eye doctor will determine if the surgery can be done with
local or general anesthesia.

You may need to position yourself in a certain way at home for a while. Your doctor will tell you what position to lie in so that the gas or oil can push against the detachment.

Contact your doctor right away if you notice any signs of
complications after surgery, such as:

An oil bubble can be used in this surgery. Because an oil bubble
does not move around in the eye as much as a gas bubble moves around, your eye doctor may suggest this type of surgery instead of other retinal detachment surgeries. The oil bubble may make the surgery and
recovery easier for older adults, young children, and anyone who may have
trouble keeping his or her head and eye in the proper position.

How Well It Works

Vitrectomy has been shown to greatly
improve
visual acuity in many people who have severe vitreous
hemorrhage that has not cleared on its own.

In general, surgery can restore
some vision that is lost as a result of traction retinal detachment and may help
prevent further detachment. But the results tend to be better when the
detachment has not affected the center of the retina (macula) and the
central vision it provides.

Risks

Vitrectomy may cause elevated pressure inside the
eye (intraocular pressure, or IOP), especially in people who have
glaucoma.

There are several other
serious, vision-threatening risks linked to vitrectomy. These
include:

What To Think About

One of the main uses of vitrectomy
is to remove blood from the middle of the eye, a condition called vitreous
hemorrhage. When vitreous hemorrhage occurs, some doctors may recommend waiting
several months to a year to see whether the vitreous gel will clear on its own
before they do a surgery that can have serious complications.

But if the hemorrhage is causing severe vision loss or is preventing
treatment of severe retinopathy, surgery may be done sooner rather than
later. Some studies have shown that long-term results are better with early
vitrectomy.

There are a few ways to repair a retinal
detachment. The chance that each surgery type can help restore good vision
varies from case to case. The cause, location, and type of detachment usually
determine which surgery will work best. Other conditions or eye problems may
also play a role in the decision.

You may
need more than one surgery to reattach the retina if scar tissue from the first surgery grows over the surface of your retina.

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